SPH Case Manager
Lenmed Private Hospitals
The Lenmed Group is committed to creating places of healing for our communities. We focus on attracting the best expertise and we are dedicated to building a steadfast and devoted team. Main Focus Areas The Case Manager utilising clinical knowledge and expertise, mitigates financial risk through comprehensive and accurate coding of hospital events, communication with funders on justification for hospitalisation level of care and length of stay. Key Performance Areas: (include but are not limited to) Responsible for application of clinical knowledge in justifying patient hospitalisation in terms of treatment, length of stay and level of care. Monitor and action risk related to medical aid benefits and hospitalisation. Ensure accurate, specific and comprehensive clinical coding Timeous, effective communication and follow up with medical aids. Review authorisation aspects approved, mitigating financial risk and final releasing the cases for billing. Liaise with a network of internal and external stakeholders regarding patient treatment. Adhere to the Managed Health Care rules of engagement. Compliance with all industry relevant legislative acts, regulations and circulars Good communications and interpersonal skills Post Requirements: (include but are not limited to) B Degree/Diploma Nursing qualification and/or Case Management qualification Diverse clinical nursing experience Case Management experience ICD-10 / CPT Coding Qualification or Experience SAP IS-H experience advantageous Proficiency in Microsoft Office products Deadline:30th September,2026
Vacancy posted 6 days ago
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